HISTORY OF ORTHOPAEDIC SURGERY
Ignacio V. Ponseti, M.D.
The word Orthopedia was used for the first time as the
title of a book published in 1741 by Nicholas Andry, Pro-
fessor of Medicine at the University of Paris. Andry
formed the word Orthopedia out of two Greek words,
orthos meaning straight, free from deformity and paidios,
a child. Professor Andry writes "out of these two words I
have compounded that of orthopedia, to express in one
term the design I propose, which is to teach the different
methods of preventing and correcting the deformities of
children." In the book there is depicted a crooked young
tree attached to a straight staff to exemplify his philoso-
phy. According to Andry, posture and proper muscle bal-
ance play a major role in the symmetrical development of
the skeleton. Andry studied deformities of the spine, head
and neck, and the extremities. "In the absence of trauma
or destructive disease-he says-crookedness of the spine
derives from asymmetrical pull of the muscles of the
trunk." In the prevention of the deformity great attention
is paid to postural training when sitting and standing.
Proper posture and regular, adequate exercises are to be
considered a necessary part of every child's upbringing.
Andry advised parents not to bind their babies too snugly
to prevent a narrow chest and short clavicles. The child
should be fitted with a corset when getting up after an
illness requiring prolonged bedrest. Andry observed that
the proportion of the length of the trunk to the legs
changes with age and that supportive apparatus may be
necessary during fast growth in adolescence to prevent
spinal deformities.
In the middle ages the deformed and the lame were
ostracized from society and considered unfortunate incur-
ables. A concern for the crippled developed gradually only
after the radical philosophical and scientific revolutions
that occurred in the Renaissance. The crippled was not
considered a social problem until the 17th century. In
1601 England established the Poor Relief Act, the first
statute enacted by a European government specifically
mentioning the crippled and providing to some extent for
his care. Thus, the crippled came into community con-
sciousness as a public charge, and the medical profession
gave its attention to the cure, prevention, or relief of the
lame and deformed body.
The orthopedists of the 17th and 18th century had a
large body of knowledge on crippling deformities gath-
ered by Greeks, Romans, and Renaissance physicians.
The books of the School of Hippocrates of fractures, and
on atriculations contain excellent discussions on the clini-
cal aspects and treatment of fractures and dislocation. A
carefully prescribed method of traction was used for
reduction of fractures of the long bones. The traction was
maintained during the application of the firm bandages or
splints until the part was adequately supported. It was
important to obtain proper alignment and length of the
thigh bone. "For the arm, when shortened,-Hippocrates
said-might be concealed and the mistake will not be
great, but a shortened thigh bone will exhibit the man
maimed." Early mobilization of the fractured extremity
was recommended. "It should be kept in mind-he
added-that exercise strengthens and inactivity wastes."
The diagnosis and treatment of dislocations was as
carefully studied as fractures. The descriptions of shoul-
der dislocations and their care have become classic.
Reduction was effective by traction on the arm with
counter traction applied to the axilla using the heel of the
operator as we do even today.
Clubfoot was recognized as a congenital deformity and
treatment was said to be most effective when applied at
the earliest possible time. Repeated manual correction
was attempted, with strong bandages applied during the
process. Overcorrection was said to be essential and the
foot was to be maintained in the position over a long
period of time. Later, specially devised shoes were to be
worn to prevent a relapse which they knew was more than
likely to occur.
Deformities of the spinal column were intensively stud-
ied. The deformity could be caused by fractures and dislo-
cations of the vertebrae, or by disease. A possible relation-
ship between the spinal gibbous and pulmonary disease
was first suggested in the Hippocratic text on articula-
tions. (Final confirmation of the connection between ver-
tebral disease and pulmonary tuberculosis, however, was
to wait for the work of Delpech and the pathologists of the
19th century.) But the Greeks knew that "there are many
varieties of curvatures of the spine even in persons who
are in good health: for it takes place from natural confor-
mation and from habit and the spine is liable to be bent
from old age and from pains." The serious consequences
and the possible progression of a spinal deformity, what-
ever its etiology, were fully appreciated. Although the
treatment of a spinal deformity was considered to be usu-
ally ineffective, it was always assiduously attempted. Var-
ious methods were devised with a view to reducing the
visible deformity. The patient was placed in traction on a
bench and compression was applied on the gibbous. The
extension bench described by Hippocrates has been cop-
ied and modified throughout the ages into recent times.
Volume 11 59
I. V Ponseti
Galen contributed greatly to the understanding of mus-
cle contracture and on the significance of nerve fibers
entering each muscle. "The principle of motion comes
from the brain and travels through the nerves," Galen
said. He called the nerve impulse a vital humor. Galen's
contributions to the clinical practice of orthopaedics were
few and he followed Hippocrates whose practice he emu-
lated. He's believed to have coined the words kyphosis,
lordosis, and scoliosis to connote those deformities
described in the Hippocratic text. After Galen there is
nothing important in the orthopaedic literature until the
11th century. At that time students from all parts of
Europe went to Salerno where the study of anatomy was
emphasized as an essential basis for surgical practice.
From Salerno came Roger of Parma who wrote near the
end of the 12th century the first great book on surgery in
Western Medical Literature. In it is found much of the
Greek material with little trace of Arabian influence.
From Salerno, surgery moved up the Italian peninsula to
the newly created University of Bologna in 1113. Bologna
still ranks as a foremost center of orthopedic surgery. In
Bologna effective and simple braces were devised, such as
spinal supports and splints for fractured femurs. Saliceto
wrote in 1275 his important book on "Cyrurgia" which is
considered to be the best work on anatomy before the
Renaissance. Saliceto preferred the scalpel to the cautery
and insisted upon cleanliness when operating and the
avoidance, when possible, of trauma and manipulation. In
Bologna was taught the fundamental doctrine of antisep-
sis as practiced by the Hippocratic school as well as the
avoidance of wound contamination.
Later, Guy de Chauliac (1300-1368), a Professor at the
University of Montpelier, wrote in his book "La Grande
Chirurgie" on the use of weights and pulleys for continu-
ous traction in the treatment of fractures of the femur.
During the 15th and 16th centuries there was a com-
plete review of anatomy based upon meticulous dissection
of the human body. Leonardo da Vinci (1452-1519) was
the leader of the scientific method of research which cul-
minated in the work of Vesalius. Leonardo was a student
and later an instructor of anatomy, and he made many
original observations concerning the origin, insertions,
and functions of the muscles of the human body. He
evolved two important principles of muscle function;
mechanical leverage and synergistic action upon which
muscle balance depends. Leonardo worked assiduously
for many years with his teacher, a very prominent anato-
mist, Marc Antonio della Torre. Leonardo's "Quaderni
dan'Anatomia" was lost for 200 years. In the 18th century
William Hunter discovered portions of this work in the
British libraries and more was discovered in Italy. Most
are now in the Royal Library at Windsor. Great anato-
mists contributed to the advance of this science, among
them are Vesalius, Falopius, Servetus, and Eustachio.
60 The Iowa Orthopaedic Journal
The work of Vesalius at Padua "De humani corporis
fabrica," published in 1543 is a landmark in the history of
medicine; books I and II, on bones, ligaments, and mus-
cles have figures of superlative excellence and accuracy.
Following the Renaissance many hospitals were built in
Europe to house the sick and the crippled. Skeletal
deformities were treated by massage, manipulation and
braces. Frances Glisson wrote in 1650 an important mono-
graph on rickets. Glisson also described patients with
achondroplasia which he considered to be fetal rickets. In
his monograph there is a clinical description of infantile
scurvy. Spinal deformities were apparently very common
and most were thought to be due to rickets. Spinal caries
is often termed Pott's disease; Pott in 1779 did not
describe the disease or its tuberculous nature but only the
deformity and its sequelae. The tuberculous nature of the
gibbous had been surmised by Hippocrates and also by
Galen and was finally established by Delpech.
Although much effort was devoted to the treatment of
skeletal deformities with Orthopedic apparatus, real prog-
ress would come only from the discoveries in anatomy,
physiology, chemistry, pathology, and from the under-
standing and control of infectious diseases.
Hieronymus Fabricius studied at Padua where he suc-
ceeded his master Gabriel Fallopius as teacher of anatomy
and surgery. Fabricius (1537-1619) was the author of the
first illustrated work on embryology and he depicted the
valves in the veins. He described an apparatus for the cor-
rection of torticollis and another for the gradual reduction
of the gibbous. He did not accept the Hippocratic sugges-
tion of forcible correction of spinal deformities, and advo-
cated the use of gentle manipulation with repeated adjust-
ments of the spinal brace. William Harvey studied under
Fabricius. His discovery of the circulation of the blood in
1628 had been paved by the discovery of the valves in the
veins by Fabricius and by that of the lesser circulation by
the Catalan Servetus. Harvey's work was the basis of
modern rational medicine.
With a rudimentary microscope, the Dutch Anton Van
Leeuwenhoek observed the striped character of muscle
and its sarcolemma. Toward the end of the 17th century,
Baglivi noted the existence of two types of muscle tissue,
the striped and the smooth. This century saw the rise of
the physical sciences, and physicists were successful in
giving mathematical expression to mechanical events.
The Italian physicist Alphonso Giovanni Borelli (1608-79)
was a pupil of Galileo. In his book "De Motu Animalum",
published in Rome in 1608, Borelli investigated the action
of muscle contraction on bones of man and animal. His
analysis evolved into a system describing the mechanics
of walking, running, jumping, weightlifting, birdflight,
fish motion, and insect creeping. He was a representative
of the iatrophysicists, who explained animal activity and
physiology as rigid consequences of the laws of physics

and mechanics. Thus, heartbeat was a simple muscular
contraction, and the circulatory system was hydraulic in
principle. Steindler, who introduced the study of biome-
chanics to American Orthopedics, referred to Borelli as
"the real founder of modern kinetics".
Thomas Sydenham of London, in the second part of the
17th century, studied the natural history of disease, thus
reviving the interest of the Hippocratic school of medicine
in early Greece. He described accurately gout as well as
scurvy which was frequently epidemic at that time among
the crews of sailing vessels.
Clinical teaching was first instituted at the University of
Leyden in 1636, and the medical school attained a reputa-
tion which rapidly surpassed even that of Padua. Herman
Boerhaave was first appointed a teacher in Leyden in
1701 and established the modern method of "bedside"
teaching and medical instruction.
Clopton Havers of London studied in the University of
Utrecht, another famous Dutch university of that period
and applied himself to the investigation of bones and
joints. His book "The Osteologia Nova" contains the first
description of the microscopic appearance of the articular
cartilage and the internal architectural of bone, including
the first account of the vascular canals of long bones
known as the Haversian canals. He did not recognize,
however, their vascular contents. Although he was a con-
temporary of Harvey, Havers did not comprehend the new
theory of circulation but retained the traditional concep-
tion of animal spirits. Havers made original observations
on the structure of cartilage and on the presence of muci-
laginous material in the cells of the synovial membrane.
Albreght Von Haller studied at Leyden with Boerhaave
in 1763 and wrote a most comprehensive treatise of eight
volumes on "Elements of Physiology of the Human Body"
which appeared in the middle of the 18th century. Haller
investigated the tendency of the muscle fibers to shorten
with any stimulus, and afterwards to expand again to
their normal length. This capacity for contraction Haller
called irritability: "a very slight stimulus produces a
movement altogether out of proportion to itself and con-
tinues to do this repeatedly as long as the fiber remains
alive." Haller noted that stimulus of the muscle contrac-
ture came by the nerves. Haller also showed that the tis-
sues themselves are not capable of sensation, but that the
nerves are the sole channels or instruments of this pro-
cess. In his book "Experiments on the Formation of
Bone" published in 1763, Haller describes the growth of
bone in fowl embryos and young chicks. The bone forms
not from the periosteum, but from the soft cartilaginous
tissue and from those tissues that surround the primordial
nucleus of ossification. Haller also studied healing frac-
tures in chickens and pigeons and observed the excep-
tional vascularity of the reparative tissues about the frac-
History of Orthopaedic Surgery
ture and finally ascribed actual osteogenic properties to
the newly formed vessels. To Haller, who lived almost a
century before the introduction of cellular histology, bone
was a substance deposited in tissue rather than the prod-
uct of local cellular activity.
In the 18th century a new chapter of physiology was
opened by the extension of the knowledge of electric phe-
nomena to the living body. Galvani of Bologna, while
investigating the susceptibility of nerves to irritation in
1791, showed a correlation between muscle twitching and
simultaneous contact with both iron and copper. He was,
in fact, producing an electrical current. Volta of Pavia
demonstrated that the muscle can be thrown into continu-
ous contraction by repeated electric stimulations.
Duchenne de Boulogne published in 1855 his basic book
on "L'electrisation Localissee" where he described with
utmost precision the action of muscles as detected by
localized electrical stimulation. He opened a new chapter
in muscle physiology, pathology, and the treatment of
paralysis.
Post mortem examinations were rarely done before
Giovanni Battista Morgagni who was Professor of Anat-
omy at Padua for 56 years. In his 79th year, in 1761, he
published his vast experience on the clinical history of the
patient, the history of his disease, and the events in con-
nection with his illness and death. In his book, "De Sedi-
bus et Causis Morbosum" (On the Seats and Causes of
Disease) conditions of the organs at some 700 post mor-
tem examination are minutely described; and the findings
are correlated with the clinical history. Morgagni intro-
duced the necessity of basing diagnosis, prognosis, and
treatment on a knowledge of anatomical lesions.
The study of the anatomical specimen was introduced
into surgery by John Hunter in London. With Hunter
(1728-93), surgery became a "real" science, replenished
with ideas drawn from comparative anatomy and pathol-
ogy. Hunter's approach was based on Hippocratic princi-
ples. He stated, "the only rational means of treatment are
those which are based on the natural recuperative power
of the body." He ruptured his Achilles tendon while danc-
ing and observed that the proximal portion was retracted
a considerable distance and the gap between the ends
became breached by simple connective tissue which sup-
plied sufficient strength to restore good function to the
ruptured tendon. His monument is the Hunterian
Museum in London. It contains the few specimens which
survived the German bombing in World War II.
In 1736 John Belchier reported to the London Philo-
sophical Society that when madder was fed to pigs and
their bones were later examined, newly formed bone was
stained red while established bone remained unstained.
Before Belchier, Duhamel had made similar observations.
This experiment became fundamental to all later research
Volume 11 61
I. V Ponseti
on bone growth and development. In more recent times,
the dye alizarine, first extracted from madder, has sup-
planted the root in the laboratory. While studying osteo-
genesis, John Goodsir from the University of Edinburg
observed in 1845 that the formation of osteoid tissue and
callus was a direct effect of the activity of the osteoblasts
in the periosteum. Later on, William Macewen from the
University of Glasgow thought that the periosteum pos-
sessed no osteogenic property, whereas Ollier in Lyon,
France, in 1867 demonstrated the importance of the oste-
ogenic property of the periosteum and thought it was
important not to damage this structure during surgery for
internal fixation of fractures.
Rudolph Virchow in the 19th century exerted a very
important influence on medical thoughts. His achieve-
ment was the extension of the cell concept to diseased
tissues. His "Cellular Pathology" published in 1858 ana-
lyzed such tissue from the point of view of cell formation
and cell structure. He described the underlying genetic
identity of bone, cartilage, and connective tissue cells
and named "osteoid" the tissue seen in rachitic bone.
Virchow's work complemented the pathological studies
of Morgagni and John Hunter with histological
observations.
A breakthrough in the history of medicine occurred in
1796 when Edward Jenner demonstrated that a condition
known as cowpox gave immunity for smallpox. Vaccina-
tion opened a new world with the study of immunity to
disease. One and a half centuries later, infantile paralysis
was controlled with a vaccine and the orthopedic surgeons
were freed from a great load of work in their practice.
The germ doctrine of disease has been the central tri-
umph of medicine during the last 100 years. The work of
Pasteur, Koch, Hansen, and Ehrlich as the founders of
bacteriology is well known to all of us. Many infectious
diseases were associated with their organisms at about
the same time near the last quarter of the 19th century. It
was then, too, that the scientific study of immunity took
great strides, and many infectious diseases were well
studied and some were controlled with "active or passive"
immunity. With Lister's development of antisepsis and
later on asepsis, surgery finally was made safe. The dis-
covery of ether anesthesia in 1846 by William Morton
made surgery painless. Through the centuries, orthopedic
surgery has been of utmost importance to the army sur-
geon. Thus a treatise on the history of orthopedics must
include a review of the treatment of war wounds.
The introduction of cannon shot in the 14th century
marked the beginning of a new type of war wound often
with extensive injuries to the skeleton. In Spain during the
siege of Malaga in 1487, Queen Isabella organized the
first field hospitals, known as ambulances, set up in sup-
port of armies in action. Ambrose Pare made the greatest
62 The Iowa Orthopaedic Journal
contribution to surgery in the 16th century. He served
three kings of France, and wrote an important treatise on
surgery, "Ten Books of Surgery." He possessed great sur-
gical skill. He advocated the introduction of maggots in
suppurating wounds when he was acting as a surgeon in
the army of Henry II. He published the first case of a
bullet imbedded in the spinal cord. He described the use
of ligatures of the veins and arteries when amputating an
extremity. Pare insisted upon the necessity for cleanliness
in all operative work and recommended the enlargement
of the wounds and the removal of all foreign bodies. He
used traction for reduction of fractures and splints for
their immobilization. He devised a large number of cor-
rective apparatus such as corsets and metal to be used for
spinal deformities, splints for fracture work, walking
splints for hip disease, and several types of shoes for
clubfeet.
It was not until 1731 that Mareschal founded the Acad-
emy of Surgery in Paris, which 11 years later obtained the
same rights and privileges as the Faculty of Medicine.
Under his influence there was founded in Russia and Aus-
tria educational institutions for military doctors which
contributed greatly to the diffusion of medical knowledge
among the surgeons of that day. The medical services in
the armies of Napoleon were efficiently organized by two
notable military surgeons, Pierre Percy and Dominic Lar-
rey. Larrey was gifted with great manual dexterity and
operated with extreme rapidity. The wounds were
debrided widely but the death rates in the hospitals in the
Napoleonic Wars in 1813 and 1814 exceeded 28%. During
the Franco-Prussian war of 1870 Ollier made his first
observations on the treatment of wounds by the use of the
occlusive method. This method was essentially the same
as that which half a century later was to be made known
by Winnett Orr throughout the world. About this time
Joseph Lister introduced antisepsis and later asepsis and
made possible the exploration of new fields of surgical
technique. John Hunter considered that war wounds vary
considerably. The small wound of entry of a bullet may not
need to be debrided, whereas a large wound must be
explored and thoroughly cleaned.
In World War I, the surgeons at first tended to make
wide incisions for debridement and used a variety of anti-
septics. Carrel used continuous hypochlorite irrigation by
which a sterilization of the wound was achieved with a
minimum of disturbance of the healing process. Second-
ary suture was used on a wider scale, often with disas-
trous results with later sepsis. In the later stages of the
war, two surgeons from the United States, William Baer
and Winnett Orr, began detailed studies of certain thera-
peutic principles which at that time were not generally
known or accepted. In Spain, the war of 1936-39 made
possible a large scale practical application of the sugges-

tions put forward by these American surgeons. Orr stated
that rest is as important to the healing of the wounds of
soft tissue as it is for the healing of broken bones. To evac-
uate soldiers with open wounds and fractures from
Europe to the United States, he dressed the wounds with
Vaseline gauze and covered them with a plaster cast
applied to the affected extremity. In most instances, when
the soldiers arrived in the States, the wounds were much
improved and healed. Following the war, Orr published
his cases of compound fractures treated by wound exci-
sion and immobilization in plaster. He extended these
principles to the treatment of osteomyelitis.
In the Spanish War, Trueta introduced Orr's technique
with some modifications that decreased mortality in the
hospitals to 0.6%. The wounded extremity was thor-
oughly washed with soap and water with a nail brush until
the wound itself was bleeding. The skin edges of the
wound were excised as well as old contused tissue, and
the wound was widened as much as required. Nonviable
muscle and connective tissues were thoroughly removed
as well as all foreign organic matter. Once the fracture
was reduced, the wound was dressed with gauze and the
extremity was immobilized in a plaster cast including the
two adjoining joints. In wounds with deep cavities, drain-
age was provided by opening up the aponeurotic planes
and the intermuscular spaces. This drainage was main-
tained open by the insertion of sterile gauze or a rubber
tube. Retained discharge, which is the result of bad drain-
age, may bring about disaster. This same treatment was
widely used in World War II and in Korea and Vietnam.
The use of antibiotics greatly enhanced survival rate in
these wars and made successful "delayed primary wound
closure" and early skin grafting of the wounds feasible.
Modern vascular surgery was first applied in the Korean
war and contributed greatly to the decrease of the ampu-
tation rate of severely wounded extremities.
Improved surgical techniques and applied bioengineer-
ing have changed the practice of orthopaedic in the past
50 years. Probably the most successful innovation has
been the improvement of the hip arthroplasty with a total
hip replacement designed by Professor John Charnley of
the University of Manchester, England. Charnley
replaced the head of the femur with a metallic prosthesis
of small size to reduce the "moment" of frictional force.
This prosthesis is used in combination with a low friction
plastic socket. He developed a self curing acrylic cement
to anchor both the femoral replacement and the acetabular
high-density polyethylene socket. In developed countries,
total hip replacement is used very often for the treatment
of patients with osteoarthritis of the hip and other hip ail-
ments. The operation has been very successful in provid-
ing relief of pain and good hip motion for several years
following surgery.
History of Orthopaedic Surgery
Internal fixation of the skeleton for treatment of frac-
tures has been greatly perfected with the use of plates
and screws and other devices made of inert metallic
alloys. The three-phlanged nail devised in 1931 by Smith
Petersen of Harvard represented an important advance in
the treatment of fractures of the neck of the femur. Intra-
medullary nailing for fractures of the shaft of the femur
with the Kfntscher nail was used extensively during the
second World War, and it is a successful method of treat-
ment of femoral shaft fractures in clinical practice. Inter-
nal fixation of the shaft fractures interferes, however,
with the natural fracture callus formation and delays the
healing of fractures. In the hands of a good surgeon, inter-
nal fixation of articular fractures greatly improves the
results. Internal fixation of fractures not involving the
joints is possibly not better than the judicious application
of plaster of Paris bandages which can successfully immo-
bilize the injured extremity and allow for weight bearing
and functional use of the injured extremity. Plaster of
Paris, by the way, was first introduced by Mathijsen in
1852, a Flemish army surgeon. Plaster of Paris success-
fully replaced traditional splints made of a mixture of egg
white, gums, and resins.
When I came to Iowa City in 1941, a large number of
patients in the Orthopaedic Department had diseases
which are today practically unknown- namely residuals
of poliomyelitis, tuberculosis of bones and joints, and oste-
omyelitis. Skeletal tuberculosis decreased considerably in
Iowa during the 1930's owing to the destruction of cattle
infected with tuberculosis. The disease was nearly com-
pletely eradicated in the late 1940's with the advent of
streptomycin. Osteomyelitis was also controlled in the
1940's with the advent of penicillin although it is still seen,
mainly as a complication of open fractures. Poliomyelitis
disappeared in the early 1950's with the advent of the
polio vaccine.
Originally, the orthopedist primarily was concerned
with the care of the crippled child; now they have to deal
with a number of poorly understood disorders of growth
and development of the skeleton, degenerative arthritis,
and congenital deformities. Now the specialty occupies a
prominent role in all modern hospitals throughout the
world. The American Academy of Orthopaedic Surgeons
has over 12,000 members. The Academy defines ortho-
paedic surgery as "the medical specialty that includes the
investigation, preservation and restoration of the form and
function of the extremities, spine and associated struc-
tures by medical, surgical, and physical means." The
Academy's seal of office is the crooked tree in Andry's
book.
Henry Mankin, Professor of Orthopaedics at Harvard,
stated that "future changes in orthopaedics will be based
in biology and more specifically in our ability to under-
Volume 11 63
 L V Ponseti
stand and alter the basic unit, the cell." Much effort is
being devoted to the study of the skeletal connective tis-
sue cell and their matrices. The electron microscope, x-
ray diffraction, and other instrumental analyses have
allowed detailed examination of cells, cell organelles, and
extracellular matrices of fibroblasts, chondrocytes, osteo-
blasts, and osteocytes. Much has been learned of the
function of these cells and of the composition of the extra-
cellular matrices, particularly of collagen and proteogly-
cans through the efforts of biologists and biochemists, but
much remains to be done.
SUGGESTED READING
(These books can be found in Dr. Martin's Rare Book
Room in the Hardin Medical Library at the University of
Iowa.)
' Andry, Nicolas: L Orthopedie. Paris, 1741.
2. Hippocrates: a) Opera Omnia Quae Extant. Frankfurt,
1595. b) The Genuine Works of Hippocrates, by Francis
Adams, London, 1849
3 Delpech, Jacques Mathieu: De l'orthomorphie. Paris,
Gabon,1828.
4' Galen: De Ossibus. Lyon, 1549.
5' Saliceto, Gulielmus de: La Ciroxia Vulgarmenta Fata.
Venice, Fide Pierto, 1474.
6. Guy de Chauliac: La Grande Chirurgie, Rouen, 1615.
7 Leonardo da Vinci: Quaderni d' Anatomia. Christiania,
1911-1916.
8. Vesalius: "De Humani Corporis Fabrica". Basel, 1543.
9 Glisson, Frances: Fractures de Rachitide Sive Morbo
Puerili. The Hague, 1682.
10. Farbricius, Hierouyums: Opera Omnia Anatomica et
Physiologica. Leyden, 1738.
64 The Iowa OrthopaedicJournal
11. Harvey, William: De Motu Cordis. Frankfurt, 1628.
12- Borelli, Alfonso Giovanni: "De Moto Animalum".
Rome, 1680.
13. Sydenham, Thomas: Opera Omnia. Geneva, 1716.
14. Havers, Clopton: Osteologia Nova-or New Observa-
tions of the Bones. London, 1691.
15. Haller, Albreght von: "Experiments on the Formation
of Bone". London, 1763.
16. Haller, Albreght von: Elementa Physiologiae Corporis
Humani. Lausanne, 1757.
17- Duchenne de Boulogne: "De L'electisation Localisee,"
Paris, 1872.
18- Morgagni, Giovanni Batista: "De Sedibus et Causis
Morbosum" (on the Seats and Causes of Disease). Venice
1761.
19. Hunter, John: A Treatise on the Blood, Inflammation
and Gun-shot Wounds. London, 1794.
20.
Virchow, Rudolph: "Cellular Pathology". Berlin, 1858.
21.
Ollier, Xavier: Osteogenic Property of the Periostium.
Paris, 1867.
22.
Pare, Ambrose: Opera Chirurgica. Frankfurt, 1594.
23- Dupuytren, Guillaume: Clinical Lectures. Paris, 1832-
1834.
24.
Pott, Percivall: Some Few General Remarks on Frac-
tures and Dislocatons. London, 1769.
25.
Steindler, Arthur: Mechanics of Normal and Pathologi-
cal Locomotion in Man. Springfield, Ill., 1935.
26.
Orr, Winnet: Osteomyelitis and Compound Fractures
and Other Infected Wounds. St. Louis, 1929.
27- Trueta, Josep: Treatment of War Wounds and Frac-
tures. London, 1939.